To the Editor. —
The last part of the conclusion reached by Abbott et al1 concerning the impact of diabetes on survival following myocardial infarction warrants closer scrutiny. They state, in the abstract: "We conclude... in addition, when cardiac failure appears, control of diabetes assumes added importance, particularly in women, where its effect on survivorship is considerable."The data presented in this communication do not address this issue nor support this statement. While it would be nice to believe that control of diabetes once congestive heart failure supervenes after a myocardial infarction prolongs survival, I am unaware of evidence that supports this theory. Indeed, studies are now ongoing to determine whether control of diabetes can delay or ameliorate the long-term vascular complications of the disease.A second concern is the comment by the authors that diabetes in women also seems to be more severe because a greater percentage of
Matz R. Does Control of Diabetes Prevent Vascular Complications? JAMA. 1989;261(23):3409–3410. doi:10.1001/jama.1989.03420230061019
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